Assessment of the role of albuminuria and uromodulin in the early diagnosis of renal function disorders in some types of obesity phenotypes

The aim: to study of the relationship of biological markers reflecting damage of the kidneys with its functional state, as well as with clinical, metabolic, hormonal parameters and immunoinflammatory processes in obesity phenotypes.

Patients and Methods: The study involved 224 obese Uzbek women who were divided into 2 groups according to the recommended criteria for metabolic syndrome: group 1 consisted of 133 women diagnosed with metabolic complicated obesity, average age 42.0±0.5; Group 2 consisted of 91 women diagnosed with metabolic healthy obesity, average age 41.7±0.7. The control group consisted of 45 healthy volunteers (women, mean age 43.2±0.8, body mass index ˂ 30 kg/m2, waist circumference less than 80 cm). In the observation groups, anthropometric indicators, blood pressure, biochemical tests and blood lipid spectrum, levels of leptin, insulin, cystatin C and uromodulin in the blood serum, gradations of microalbuminuria in urine were determined, the glomerular filtration rate was calculated for cystatin C and creatinine and the obtained indicators were compared.

Results. In both obesity phenotypes, the amount of microalbuminuria and cystatin C significantly increased in group 1 compared to these indicators in group 2 and the control group, and the amount of uromodulin in the blood serum, on the contrary, decreased compared to the indicators in group 2 and control group (r ˂ 0.001) . An increase in the gradation of microalbuminuria and cystatin C and a decrease in the amount of uromodulin in the blood serum in both groups was expressed by a decrease in the estimated glomerular filtration rate, which was clearly expressed in group 1 (χ2 = 4.5, r = 0.034). Also, an increase in body mass index was characterized by an increase in cardiometabolic disorders, an increase in the gradation of microalbuminuria, a decrease in the level of uromodulin in the blood serum and cytokinemia (p ˂ 0.001).

Conclusion. In both obesity phenotypes, an increase in the degree of obesity was manifested by an increase in the level of cardiometabolic risk, as well as an increase in subclinical kidney damage. It is considered appropriate to determine the amount of uromodulin and cystatin C in blood serum and assess the gradation of microalbuminuria in the early diagnosis of renal dysfunction in obesity.

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